This specialized branch of physiotherapy treats both the internal and external pelvic floor muscles. The pelvic floor consists of a group of muscles that attach throughout the inner pelvis, creating a sling-type structure. The sling of pelvic floor muscles needs to contract and relax to allow urine and fecal continence, support your organs, stabilize your pelvic girdle as well as provide sexual satisfaction. However, when this pelvic sling is not functioning properly, it can lead to some embarrassing and uncomfortable concerns for both men and women. Often, these concerns are the result of pelvic muscles that are too tight or too weak.
A pelvic floor that is too weak can contribute to urine leakage when laughing, sneezing or playing sports. Another common presentation of weakness is pelvic organ prolapse. Prolapse occurs when the pelvic organs move from their secured position in the pelvis, giving the sensation of heaviness at the vaginal or rectal opening. A weak pelvic floor is a common issue during or after pregnancy.
A pelvic floor that is too tight can contribute to incontinence and pelvic pain. Urinary Incontinence is urine leaking out when you are unable to make it to the toilet in time. Other symptoms can include an urgent need to use the bathroom or pain and straining with bowel movements. Pelvic pain is a term used to describe the inability or pain with vaginal penetration, orgasm, erections or any sexual stimulation as the result of a pelvic floor that is too tight.
Many patients incorrectly assume these symptoms of weak or tight pelvic floor muscles are a normal aspect of aging or motherhood. Often these sufferers will do their Kegels and hope for the best without knowing the true ‘status’ of their pelvic floor. Unfortunately, Kegels are not always beneficial and can make symptoms worse. To truly understand the ‘status’ of an individual’s pelvic floor, both an external and internal evaluation by a pelvic therapist is required.
Many people express concern at the thought of an internal exam. For both males and females, the internal and external exam is guided by each individual’s expressed concern in conjunction with their answers to diagnostic questions. An internal exam is not always indicated and will only be conducted if the therapist determines it will provide additional diagnostic value and the patient is comfortable. In saying this, an internal exam is considered the gold standard in adequately assessing the pelvic floor. Keep in mind, some pelvic floor issues are too painful to allow for an internal exam. In these cases, the practitioner will depend solely on the external component of the exam.
The assessment and treatment of pelvic floor dysfunction is a patient-led process. Individuals with pelvic floor concerns are encouraged to schedule an appointment with a pelvic floor therapist to discuss assessment and treatment options to see how pelvic therapy can help improve their sexual and pelvic health.